Doppler ultrasonography combined with transient elastography improves the non-invasive assessment of fibrosis in patients with chronic liver diseases
| Autor: | Tomica Milosavljevic, Zoran Stojanovic, Simon Zec, Vera Matovic, Vladimir M. Nikolic, Tamara Alempijevic, Aleksandar Veljkovic |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Liver Cirrhosis Male medicine.medical_specialty Acoustics and Ultrasonics Diastole Splenic artery Chronic liver disease Sensitivity and Specificity Young Adult 03 medical and health sciences Elasticity Imaging Techniques 0302 clinical medicine Fibrosis medicine.artery medicine Humans Radiology Nuclear Medicine and imaging 030212 general & internal medicine Aged Radiological and Ultrasound Technology medicine.diagnostic_test business.industry Liver Diseases Reproducibility of Results Ultrasonography Doppler Middle Aged medicine.disease 3. Good health medicine.anatomical_structure Liver ROC Curve Liver biopsy Chronic Disease Female 030211 gastroenterology & hepatology Radiology Transient elastography business Artery |
| Zdroj: | Medical Ultrasonography. 19:7 |
| ISSN: | 2066-8643 1844-4172 |
| DOI: | 10.11152/mu-921 |
| Popis: | Aims: Accurate clinical assessment of liver fibrosis is essential and the aim of our study was to compare and combine hemodynamic Doppler ultrasonography, liver stiffness by transient elastography, and non-invasive serum biomarkers with the degree of fibrosis confirmed by liver biopsy, and thereby to determine the value of combining non-invasive method in the prediction significant liver fibrosis. Material and methods: We included 102 patients with chronic liver disease of various etiology. Each patient was evaluated using Doppler ultrasonography measurements of the velocity and flow pattern at portal trunk, hepatic and splenic artery, serum fibrosis biomarkers, and transient elastography. These parameters were then input into a multilayer perceptron artificial neural network with two hidden layers, and used to create models for predicting significant fibrosis. Results: According to METAVIR score, clinically significant fibrosis (≥F2) was detected in 57.8% of patients. A model based only on Doppler parameters (hepatic artery diameter, hepatic artery systolic and diastolic velocity, splenic artery systolic velocity and splenic artery Resistance Index), predicted significant liver fibrosis with a sensitivity and specificity of75.0% and 60.0%. The addition of unrelated non-invasive tests improved the diagnostic accuracy of Doppler examination. The best model for prediction of significant fibrosis was obtained by combining Doppler parameters, non-invasive markers (APRI, ASPRI, and FIB-4) and transient elastography, with a sensitivity and specificity of 88.9% and 100%. Conclusion: Doppler parameters alone predict the presence of ≥F2 fibrosis with fair accuracy. Better prediction rates are achieved by combining Doppler variables with non-invasive markers and liver stiffness by transient elastography. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|